Provider Demographics
NPI:1407831852
Name:CORMAN, LARRY I (MD)
Entity type:Individual
Prefix:DR
First Name:LARRY
Middle Name:I
Last Name:CORMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:849 LINWOOD ST
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-3526
Mailing Address - Country:US
Mailing Address - Phone:707-448-2449
Mailing Address - Fax:
Practice Address - Street 1:2516 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2208
Practice Address - Country:US
Practice Address - Phone:916-734-7618
Practice Address - Fax:916-734-7890
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG 236162080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases